Pyometra with inguinal herniation of the left uterine horn and omentum in a Beagle dog

Objective: To describe a unique case of pyometra with inguinal herniation of the left uterine horn and omentum. Case summary: A 7‐year‐old, 19 kg, intact female Beagle dog presented for surgical treatment of presumptive pyometra and biopsy of a caudal abdominal mass in the left inguinal mammary gland region. Ventral midline celiotomy was performed, and a distended, fluid‐filled uterus with passage of the distal aspect of the left uterine horn through the left vaginal process into the inguinal canal was identified. The patient recovered uneventfully following ovariohysterectomy and left inguinal herniorrhaphy. New or unique information provided: This is the first documented report of inguinal herniation of a uterine horn associated with a pyometra.     

Pyometra in an Inguinal Hernia in a Bitch

Pyometra in an inguinal hernia was diagnosed in a 10‐year‐old intact cross‐bred bitch which had had dysorexia, depression and inguinal distension. The hernia contained caudal portions of the two uterine horns, uterine cervix and cranial part of the vagina. As the organs were enlarged and full of pus, manual attempt to push back the uterine horns and the vagina in the abdominal cavity through the inguinal canal was unsuccessful. Herniated uterine horns were ligated and cut in their median portion, so it became possible to remove the cervix and the caudal portion of the horns through the hernial orifice, and the ovaries and the cranial part of the horns through a peritoneal midline incision. This bitch was not intended for breeding purposes and, given the presence of a huge pyometra associated with an inguinal hernia, an ovario‐hysterectomy was recommended. Uterine herniation should be considered as a differential diagnosis of a caudal lateral inguinal mass. When pushing the uterus back in the abdominal cavity is impossible, a surgical procedure should be performed to detect ischemia–reperfusion injury and/or a septic risk.     

XY male pseudohermaphroditism in a captive Arabian oryx (Oryx leucoryx).

A 2-yr-old Arabian oryx (Oryx leucoryx) was presented for evaluation of abnormal genitalia and infantile behavior. The oryx had a penis and a scrotum, but testes were not palpable within the scrotum or inguinal canal. The total serum testosterone for the individual was lower than in age-matched males of the same species. Surgical exploration showed markedly hypoplastic intra-abdominal gonads, which demonstrated both testicular and uterine tissue on histologic examination. After karyotype analysis, the individual was classified as an XY male pseudohermaphrodite. This condition resembles two human intersex syndromes: embryonic testicular regression syndrome and partial gonadal dysgenesis syndrome, which occur in familial lines.     

The Case of an Sry‐Negative XX Male Pug With an Inguinal Gonad

A case of intersexuality in a Pug that was bought as a male in a pet shop is described. The dog was presented at the Veterinary Teaching Hospital, University of Turin, for a reddish mass protruding from the prepuce. The mass had the aspect of an enlarged clitoris, with a caudoventral direction and a dorsal urethral ostium. A gonad was palpable in the left inguinal region. Laparotomy confirmed ultrasound detection of an abdominal uterine structure together with the right gonad. The histology of both gonads was similar, showing an exclusively masculine character, with seminiferous tubules lined only by Sertoli cells; the uterus showed a normal histological structure. Karyological analysis revealed a female karyotype (78,XX), and polymerase chain reaction showed the absence of Sry. The diagnosis was an XX male. The pathogenesis of the XX sex reversal syndrome in dogs is not completely understood, as Sry, the master gene regulating testis differentiation, is not present; to date, no genetic cause has been identified for this phenotypic condition in dogs. This case is unusual because the dog showed an inguinal testis, implying a partial activity of the mechanisms leading to abdominal testis translocation along a gubernaculum and transinguinal migration.     

Bilateral intracorporeally sutured inguinal herniorrhaphy using 3-dimensional laparoscopy in a dog

A 7-month-old, intact male, mixed breed dog with bilateral inguinal hernias underwent general anesthesia for laparoscopic bilateral inguinal herniorrhaphy via a 3-port approach. A 3-dimensional laparoscopic system was used to perform the procedure immediately following prescrotal open castration. Intracorporeal suturing with polypropylene was performed, and 2 cruciate sutures were placed to close each inguinal ring. The caudal aspect of each inguinal ring was left slightly open so as not to disrupt the passage or patency of vessels and nerves. No intra- or post-operative complications occurred. One year after surgery, the dog has no evidence of recurrence of the inguinal hernias.Key clinical message:This case report demonstrates a novel minimally invasive approach to inguinal herniorrhaphy in a dog with no reported complications and a good long-term outcome. Intracorporeally sutured inguinal herniorrhaphy is feasible in dogs with good results, although additional cases are needed to gain experience with this technique in dogs with varying presentations of inguinal hernias.     

Herniation of the urinary bladder through a congenitally enlarged inguinal canal in a cat

A two-year-old, castrated male Main Coon cat was referred because of chronic, recurrent pollakiuria, haematuria, and acute vomiting. On clinical examination, a smooth, soft-tissue mass, suspected to be the urinary bladder, was palpable outside of the abdominal wall in the inguinal area. On radiographs, the urinary bladder was found to be extra-abdominal, and herniated through an enlarged right inguinal canal at exploratory coeliotomy.The left inguinal canal was also enlarged. The urinary bladder was repositioned and fixed to the caudal abdominal wall by incisional cystopexy and both enlarged inguinal canals were partially closed with an interrupted suture pattern.     

¹⁸F-FDG and ¹¹C-MET positron emission tomography findings of cutaneous mast cell tumor in a dog

A 12-year-old intact male Maltese dog presented with an inguinal mass. Histopathology revealed a grade III mast cell tumor. Computed tomography demonstrated pulmonary and inguinal nodules and masses. Chemotherapy was performed using a vinblastine/prednisone protocol, and the inguinal mass disappeared 5 weeks later. Use of 2-deoxy-2-[1?F]fluoro-D-glucose (1?F-FDG) and (L)-[methyl- 11C]methionine (11C-MET)-positron emission tomography (PET) demonstrated hypermetabolic areas in the lungs and inguinal region one week after initial chemotherapy. The standardized uptake values of 1?F-FDG were not different between lung and inguinal lesions; however, the inguinal lesion had a higher 11C-MET standardized uptake value than the lung lesions. The hypermetabolic area was still visible on the second 1?F-FDG-PET scan despite the disappearance of the mass. This is the first report of 11C-MET-PET findings associated with a cutaneous mast cell tumor in a dog.     

Inguinal enterocutaneous fistula in a dog

A two‐year‐old Jack Russell terrier presented with a chronic history of weight loss and the recent development of a discharging wound in the left inguinal region that was confirmed by ultrasound and contrast radiography to be an enterocutaneous fistula. One day following admission the dog displayed signs of abdominal pain and the general condition deteriorated. At exploratory coeliotomy there was evidence of septic peritonitis and a segment of jejunum was found firmly adhered to the left inguinal canal. The affected jejunal segment was excised and an end‐to‐end anastomosis performed. A penrose drain was placed in the inguinal wound which was subsequently managed with open drainage. The inguinal wound healed successfully by second intention and the dog returned to normal body condition. The left testis became atrophic and castration was performed several weeks later. To the authors’ knowledge this is the first veterinary case report of an inguinal enterocutaneous fistula.     

Castration of the Vietnamese pot-bellied boar: 8 cases

Surgical techniques for castration of the Vietnamese pot-bellied boar and outcome are described. Vietnamese pot-bellied pig (VPBP) boars (n = 8) were admitted for castration. Data retrieved from medical records (2002–2011) for these pigs included signalment, history, reason for castration, perioperative management, surgical technique, and complications. Follow-up information was obtained from owners. A scrotal approach with closed technique was used for 6 boars with normally descended testes. A scrotal approach and open technique was used in 1 inguinal cryptorchid boar. In a hemicastrated abdominal cryptorchid boar an ipsilateral parainguinal approach was used. No complications occurred. Castration of the Vietnamese pot-bellied boar is associated with minimal complications and a satisfactory cosmetic outcome. We recommend the routine closure of the external inguinal rings, a simple and fast procedure that may prevent post-castration inguinal herniation.     

Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis

Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate analgesia was achieved by sedation with detomidine and local flank infiltration with mepivacaine. Three portal sites at the paralumbar fossa were used to perform the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal. Subsequent adhesion formation resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive technique allowed us to perform a testis sparing herniorrhaphy in the standing horse.     

Diagnosis and successful surgical treatment of an unusual inguinal liposarcoma in a pet ferret (Mustela putorius furo)

A 4 1/2-year-old female spayed ferret (Mustela putorius furo) was presented for a rapidly growing mass in the inguinal region. Following a complete clinical evaluation, the unusual mass was surgically removed and the histopathological diagnosis was an inguinal liposarcoma. No post-operative complications were observed over a 14-month follow-up period.     

Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses

Objective— To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings.
Study Design— Case series.
Animals— Foals (n=6) and geldings (n=2).
Methods— After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close the internal inguinal and vaginal rings.
Results— There was no recurrence of inguinal hernia. Postoperative morbidity was minimal and cosmetic outcome was comparable to that achieved with conventional, open techniques.
Conclusion— Laparoscopic, primary closure of the internal inguinal ring by use of intracorporeal sutures provides a secure barrier to herniation and costs considerably less than using endoscopic staples.
Clinical Relevance— Laparoscopic suture closure of the internal inguinal and vaginal rings provides safe and effective repair of inguinal hernia in horses.     

Use of an inguinal approach adapted from equine surgery for cryptorchidectomy in dogs and cats: 26 cases (1999-2010)

OBJECTIVE-To determine whether a surgical technique used in cryptorchid horses can be used successfully to remove testicles retained in the inguinal region or abdominal cavity in dogs and cats. DESIGN-Retrospective case series. ANIMALS-22 dogs and 4 cats with cryptorchidism. PROCEDURES-In 1999 through 2010, 26 cryptorchid patients underwent surgery during which an incision was made over the inguinal ring and the undescended testicle was located for removal via identification of the vaginal process and the embryonic gubernaculum. Castration was performed once a testicle was located in the inguinal region or via removal of an intra-abdominally located testicle through the inguinal canal. RESULTS-4 dogs and 1 cat were bilaterally cryptorchid. Testicles were retained in the abdominal cavity in 18 dogs and in the inguinal region in 4 dogs; in all 4 cats, undescended testicles were located in the inguinal region. Twenty-one dogs and 4 cats were castrated without breaching the abdominal cavity; in one of those dogs, the inguinal ring was enlarged to permit extraction of a tumorous testicle. In 1 dog, the inguinal ring was enlarged into a paramedian laparotomy and viscera were manipulated to exteriorize an intra-abdominally located testicle because the gubernaculum had ruptured. Major intraoperative or long-term complications did not occur. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that as in horses, the surgical approach over the inguinal ring, wherein the vaginal process and the remnant of the gubernaculum are identified and used to locate an undescended testicle for removal, can be used successfully in dogs and cats.     

Postcastration eventration in 18 horses: the prognostic indicators for long-term survival (1985-1995).

Castration of horses is considered a common and routine surgical procedure, but the potential for complications is high. By far the most serious of these is eventration. The objectives of this study were to determine the long-term survival of horses undergoing surgical treatment of indirect (1) inguinal eventration of the small intestine following castration, and to identify prognostic indicators for survival. The case records of 18 horses undergoing surgical treatment of postcastration eventration (PCE) between 1985 and 1995 were reviewed. Follow-up information was obtained by telephone interviews 2 to 13 y postoperatively. A Cox proportional hazard regression model was fitted to determine which clinical features were of significant influence to survival. Clinical features with a significant negative influence on survival were an inguinal surgical approach for correction, an increased length of prolapsed bowel, and performance of bowel resection and anastomosis. Significant postoperative complications developed in 89% of cases; 44% of cases in the "inguinal" surgical approach group developed peritonitis, compared with 10% in the "midline" approach group. Of all horses in this study, 72% were discharged from the hospital; however, only 40% of horses in the inguinal approach group were discharged. The long term survival rate (> 1 y) for all horses in this study was 44%, with a median survival time of 3-1/2 mo.     

Uterine Motility in the Cow During Puerperium

The objective of the study was to determine uterine motility during the postpartum period in cattle. In the present study spontaneous uterine activity was recorded during postpartum period using electrodes which were surgically implanted into the myometrium 4-6 weeks before parturition. After the placenta has been released 4-8 hours post part, spontaneous uterine motility drastically decreased until the second week post part. The effects of oxytocin, depotocin, prostaglandin, ergometrin, detomidin on the uterine contractility, during postpartum period were investigated. Oxytocin and carbotocin given intravenously always provoked strong uterine contractions. Prostaglandin F2alpha and detomidinum HC1 stimulated uterine activity in the early puerperium. Following administration of ergometrin unequal response was recorded. Ultrasonographic examinations were performed daily with real time B-mode scanner equipped with a 5.0 MHz linear-array transducer (Aloka 210, Pie Medical). 10 muciparous Black-White-Holstein cows between 2 and 4 years old and 550-650 kg b.w. were used. A 6-min scan of the longitudinal view of the uterine body was recorded using video cassette recorder connected to the ultrasound scanner. A scoring system was used to determines uterine motility. Contractility scores were higher just after parturition then in the following times. Blood samples were collected daily from jugular vein for plasma progesterone and estrogen concentrations. Changes in uterine activity were associated with plasma progesterone and estrogen level.     

Laparoscopic inguinal herniorrhaphy with barbed suture in a ram

A 7-month-old Hampshire ram, with no history of trauma or breeding, was referred for treatment of acute, unilateral scrotal swelling. Physical examination revealed a moderately sized, soft, left-sided, non-reducible swelling of the proximal scrotum and mild swelling of the scrotal neck. Ultrasound evaluation of the scrotum revealed morphologically normal testicles and a mild accumulation of free fluid in the left vaginal tunic. Unilateral, laparoscopic inguinal herniorrhaphy under general anesthesia was performed. The herniated omentum was reduced and barbed suture was used to imbricate the internal inguinal ring and the vaginal ring. No recurrence of herniation was reported 5 months after surgery.Key clinical message:Laparoscopic inguinal herniorrhaphy with barbed suture can be a safe and effective means of scrotal hernia resolution in a ram. When performed by a competent surgeon experienced in laparoscopy, this treatment for inguinal and scrotal herniation may minimize post-operative pain, provide a rapid return to function, and preserve normal testicular and scrotal anatomy.     

Anatomical, cytogenetic and behavioural studies of freemartin ewes

The external phenotype and reproductive behaviour of 21 freemartin sheep and two male pseudohermaphrodite sheep were recorded with the aim of identifying any characteristics which might be used to predict a failure to breed. The size and shape of the vulva and clitoris, the length of the vagina, the size of the teats, the presence or absence of inguinal gonads, and the ultrasonographic characteristics of the inguinal gonads were recorded. A subjective assessment of the masculinity of each animal's body form was also made, and its behavioural responses to a virile ram and to an oestrus ewe were recorded. A number of physical and behavioural abnormalities were detected but the only consistent finding in all 23 animals was a short vagina which varied in length from 3.1 to 7.0 cm, compared with 10 to 14 cm in normal animals.     

Endometrial biopsy technique and uterine pathologic findings in llamas

Uterine tissue specimens from 90 llamas with history of infertility were examined and graded microscopically; 83 specimens were obtained by endometrial biopsy and 7 specimens were obtained at necropsy. Fifteen llamas (16.7%) had a normal uterus, which was graded 1A. Twenty-three llamas (25.6%) had minor uterine abnormalities that were graded 1B. Forty-five llamas (50.0%) had appreciable endometritis that was graded 2A. Three llamas (3.3%) had endometritis with gland fibrosis that was graded 2B. Two llamas (2.2%) had notable uterine gland fibrosis that was graded 3A. Two llamas (2.2%) had uterine neoplasia that was graded 3B. Thirty-six llamas had follow-up evaluation; 22 became pregnant, most after some form of treatment. Uterine biopsy in llamas was readily performed without complications and was valuable in identifying a wide range of uterine diseases, most of which were amenable to treatment.     

Uterine involution in Finnish dairy cows

The effect of parity on the cervical and uterine involution was studied in 79 Finnish dairy cows on a research farm. The cows were examined clinically by rectal palpation 3 times a week during 8 weeks postpartum. The diameters of the cervix and uterine horns were estimated manually. The parous uterine horn was compared with the non-parous one. The results were separately analysed in primiparous cows (n = 18) and in those with the third calving (n = 61). A significant difference (p less than 0.001) between the parous and non-parous uterine horns was obtained until 21 days. Thereafter, involution still continued and equal diameters for the horns were not found until 5 weeks after parturition. A decline of the cervical diameter continued until 30 days after the delivery. The parity had no significant effect on the swiftness of uterine or cervical involution. However, in multiparous cows the cervical diameter remained larger than that in the primiparous animals still at 8 weeks postpartum.